by Saloni Kumari, Nadeem Yunus and Puneet Mahajan
Case Report
Body is protected from external and internal dangers through a wide variation of defense mechanisms, some of which are involuntary. Among one of the most common reflex of oral cavity is the gag or pharyngeal reflex that is initiated in response to stimulus in the posterior parts of the oral cavity either in the maxillary or mandibular arch. Posterior palatal region is usually less sensitive to such stimuli, but underlying local and systemic conditions may bring exaggerated gag reflex. We present two cases of gag reflex that were associated with underlying systemic conditions in which one was due to nutritional deficiency and the other due to stress. Both cases presented wide clinical changes in the palatal mucosa including hypersensitive mucosa. One patient being completely edentulous was successfully treated with complete denture prosthesis while other patient received a single implant supported crown. Management of gagging during impression making was achieved by local anesthetic application, and distraction of patient. Both patients expressed their satisfaction with management of gagging and respective clinical treatments.
American Journal of Medical Case Reports. 2024, 12(4), 64-67. DOI: 10.12691/ajmcr-12-4-2
Pub. Date: April 17, 2024
by Nithisha Thatikonda, Vijaya Valaparla, Aabishkar Bhattarai, Chilvana Patel and Anand Vilaschandra Patel
Case Report
Corpus callosum infractions (CCI) are rare, accounting for only 3% of all ischemic strokes. CC derives its rich blood supply from anterior and posterior circulations with extensive anastomosis near the splenium tip, providing inherent protective redundancy to reduced blood flow. The presence of intracranial atherosclerotic disease (ICAD) impairs this cerebrovascular reserve, increasing susceptibility to ischemia and subsequent infarction. The border zone is more hemodynamically unstable when both circulations are affected simultaneously or in the presence of congenital anatomical variations in the cerebral vasculature. In such circumstances, accentuated hypoperfusion of the cerebral border zones secondary to systemic hypotension results in the development of border-zone infarct of the CC. We present a 47-year-old male with a midline border-zone infarct of CC due to diffuse ICAD with superimposed systemic hypoperfusion in the peri-procedural period of coronary artery bypass grafting (CABG). Due to the peculiar vascular involvement by ICAD, the infarction was isolated to CC, sparing the more common cortical border zones. Following the case report is a review discussing various anatomical locations, classifications, and pathophysiology of border-zone infarcts, with a specific focus on the vascular anatomy of the corpus callosum.
American Journal of Medical Case Reports. 2024, 12(4), 58-63. DOI: 10.12691/ajmcr-12-4-1
Pub. Date: April 06, 2024